Previous work by the present investigators and other have shown a significant incidence of hearing loss in chronic renal hemodialysis and renal transplant patients. After known causes such as ototoxicity, trauma, middle ear disease, presbycusis, heredity and noise exposure are eliminated a group of about 10% remain for whom the cause is obscure. This study is continuing the investigation of clinical status, past medical and family history, audiologic and vestibular test values, multiple blood chemistries, coagulation tests, medication and other treatment parameters and inner ear pathology in such patients. A population of about 450 patients has accrued, is being followed longitudinally, and the data is being assembled for statistical analysis. At present a surprisingly high percentage (17%) of living renal patients appear to have genetic hearing losses not due to Alport's disease. This segment of the patient population will also be investigated further.